| NPI | 1861262784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE B LONG Owner 727-804-8623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2024-01-02 |
| Last Update Date | 2024-01-02 |